Into the same risk pools
JD Vance wants to make medical insurance Great Again.
“You also want to implement some deregulatory agenda so that people can choose a health care plan that fits them. A young American doesn’t have the same health care needs as a 65-year-old American. A 65-year-old American in good health has much different health care needs than a 65-year-old American with a chronic condition. We want to make sure everybody is covered, but the best way to do that is to actually promote some more choice in our health care system and not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools, that actually makes it harder for people to make the right choices for their families.”
Jesus christ. How stupid do you have to be? That’s how insurance works: everyone pays in; not everyone needs to use it; it’s there for the people who do need it. Universal health care/insurance=everyone pays in and not everyone needs it. The one-size approach is the one that works; any other approach is just back to pay as you go, which does not work.
By invoking a “deregulatory agenda,” Vance is pitching a return to the bad old days when people with preexisting conditions couldn’t get coverage. Harris put this in personal terms during her debate with Trump: “I don’t have to tell the people watching tonight, you remember what that was like? Remember when an insurance company could deny [coverage] if a child had asthma, if someone was a breast cancer survivor, if a grandparent had diabetes?”
But Vance and his horrible friend want to go back to that.
Yeah, if the healthy people aren’t paying, the insurance company will spend out more than it takes in…that’s ridiculous. You have insurance you don’t need, because you know that some day, you may be the one who needs it, and you hope someone healthy is paying so you can get care…just like you did when you were young and healthy.
In short, he wants all the old people who paid insurance during their young, healthy years to have no one there to help them out now that they need it. I didn’t need much insurance when I was young, either, but my father did. My grandmother did. I was glad to pay my premium knowing it helped them.
It’s like some of the youngsters I know who think Social Security should go away because why should people be paid for doing nothing? You mean, other than the fact it’s their money that they paid in all those years ago, and they’re now getting back? Yeah, that program. None of these kids realize what could happen if SS goes away. They haven’t opened their eyes to the real possibility of Mom, Dad, Mother-in-Law, and Father-in-Law having to move in with them, sharing their not big enough house with them and their kids. (And if anyone wants to actually have to live with their kids, raise your hands. I know mine’s not up.)
The one thing the vast majority of people experience is that your health needs go up as you age. In many countries we recognise that and pay higher taxes to improve the bulk of the healthcare for everybody. It’s called society or maybe it could be called community. I suspect some people only hear socialism or communism when those words are used, but then they’re probably fine with walking past people living on the street and not seeing them either.
It betrays a fundamental misunderstanding of how risk pools work. It’s precisely because the pool is large that individual costs are low. It’s precisely because most people don’t have huge medical needs that low individual costs for everyone can absorb high individual costs for a few. If I wanted to get jargony, I’d say that a risk pool amortizes costs.
Do I really need to bust out the whiteboard and draw some damn charts? For a VP candidate?
I think part of what drives this agenda is a libertarian every-man-is-an-island ethos, and I think part of what drives that ethos is that the alternative is living in society–in community–with others, and living in community is hard, on several counts.
First, you have to deal with other people, and other people can be hard to deal with. It’s simpler if it’s just you.
Second, to remain in community you have to behave yourself. You have to accept the norms of the group.
Third, you have to trust others to be there for you when you need them. Worse, you have to admit to yourself that you are not self-sufficient and invincible. You have to admit that you do need others.
Bad behavior and a desire to be free from social constraint is easily observed on the right, but I think the real killer for these people is a lack of trust.
The ethos of J.D. Vance can be summed up with this:
“I’m alright, Jack.”